Practical Diabetology is a professional journal providing busy physicians with straightforward, practical information to enhance the care and treatment they give their diabetes patients. Articles concern all aspects of diabetes and its complications and are designed to be quickly read, easily understood, and readily incorporated into daily practice.

Evaluation of hypoglycemia can be challenging and frustrating. Patients often report symptoms of hypoglycemia with no documentation, whether by lab or personal glucose meter. With insulinoma so rarely occurring, the most common underlying diagnosis is prediabetes or early Type 2 diabetes, but it could also be liver disease or cancer.
The presence of neuroglycopenic symptoms in patients without diabetes are strongly suggestive of a hypoglycemic disorder. Conversely, there is a low likelihood of a hypoglycemic disorder in those with neurogenic symptoms in the absence of a low plasma glucose concentration.Complications and comorbidities — Hypoglycemia

Creating a therapeutic plan at the time of Type 2 diabetes diagnosis is pretty easy: one recommends therapeutic lifestyle changes and metformin therapy. If the A1C does not reach goal, the dose is increased and/or another agent is added.
However, it is not always that simple. The plan needs to be individualized. What about the possibility that a plan could be personalized from the time of diagnosis as part of a long-term road map that not only leads to the A1C goal but also proceeds to instruct the patient how to remain there? The first step would be to commit to a starting point that takes into consideration the whole patient and not just the diagnosis.Management strategies and tools

This column highlights recent clinical trial data and landmark trials to provide relevant information and links for obtaining trial data and articles to facilitate discussion with patients and other providers. The trial is identified by its acronym, its ClinicalTrials.gov Identifier (NCT Number) and its journal reference. When possible, the reference will include the study design paper and the main outcomes. If the Clinical Trial Study Group has made a slide set available, the link will be included. A summary provides primary outcome results. Selected abstracts also may be highlighted with a summary of the main points.
This issue of Journal Watch looks at three studies evaluating the cardiovascular effects of medications for diabetes, including insulin degludec, insulin glargine, canagliflozin, and metformin, in patients with diabetesClinical trials

The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention program that has proved effective. Intensive behavior change improves eating habits and physical activity while buidling problem-solving and coping skills. Trained lifestyle coaches facilitate educational sessions and physical activity opportunities and provide feedback. They help participants set personalized goals, work toward physical activity and weight loss targets, and track progress through self-monitoring of diet and activity.
The delivery of the DPP has gone from research to community settings. Its scope has evolved to have a wider reach and a bigger impact so that more people with prediabetes can affordably access this service. The program produces more than improved health outcomes and cost savings; it helps people feel better and build the energy and confidence to do things that they would have otherwise been unable to do.
When we hear about the impact the DPP has on people’s lives, we are excited to encourage others to bring the DPP to their own community. How exactly do you do that? It’s just like what we tell people about managing diabetes: “Make a plan. It’s not easy, but it’s worth it.” You can do it by building your skill set and using available tools to develop a sustainable program.Educator's Corner